Provider Demographics
NPI:1851414650
Name:CHANIN, RICHARD JEFFREY (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JEFFREY
Last Name:CHANIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COMPTON RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3826
Mailing Address - Country:US
Mailing Address - Phone:513-729-2800
Mailing Address - Fax:
Practice Address - Street 1:800 COMPTON RD
Practice Address - Street 2:SUITE 15
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3826
Practice Address - Country:US
Practice Address - Phone:513-729-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15635122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist